Akciğer Malignitelerinde Radyofrekans Ablasyon Tedavisi: Sonuçlar ve Sağkalıma Etkisi

Abstract

The aim of this study is to determine the efficiency of radiofrequency ablation (RFA) and its effects on survival for primary and secondary lung tumors. Forty-six patients, of whom 8 had primary and 38 had secondary lung cancer underwent RFA from June 2005 to February 2013. A total of 110 lesions, of which 9 were primary (non-small cell lung cancer) (8%) and 101 were metastatic (92%) were treated with 119 RFA sessions. Complete necrosis was obtained in 91 lesions (82.7%) (5 primary and 86 metastatic lesions) after the first RFA procedure. Local tumor progression at the initial RFA site occured in 4 primary and 15 metastatic with a total of 19 lesions (17.2%). Local tumor progression took place 1-20 months (median 7 months) after the initial ablation. Among the progressed lesions, 9 were (2 primary, 7 metastatic) re-treated with RFA. Lesion diameter ranged from 0.6 to 4 cm (median 1.5 cm). The survival end points were analyzed using Kaplan-Meier method. One and 2-year overall survival rates of 8 patients with primary lung cancer were 69% and 46% respectively. Tumor-free survival rate was 15% at 1 year. One-, 2-, 3-, 4-, and 5-year overall survival rates for 38 patients with secondary lung tumors were 87.9%, 74.6%, 58.7%, 53.4%, and 31% respectively. One-, 2-, 3-,4-, and 5 year tumor-free survival rates were 43.8%, 27%, 25.3%, 16.8%, and 11.2% respectively. One-, 2-, 3-, and 4-year overall survival rates for 16 patients with pulmonary colorectal metastases were 91%, 80%, 64%, and 13% respectively. One-, 2-, 3-year tumor-free survival rates were 26%, 17%, and 6% respectively. There was no procedure related mortality. Complications occurred in 20 sessions (16.8%). Pneumothorax occurred in 18 sessions with 6 requiring percutaneous chest tube drainage. In conclusion, RFA is a safe and effective treatment in properly selected patients with primary and secondary lung tumors. RFA prolongs overall and tumor-free survival time, and enables local tumor control.